Low self-esteem linked to poorer perceived nasal function

By Bianca Nogrady 
Poor mental health may be associated with poor perceived nasal function even in the absence of true obstruction, according to a study published in JAMA Facial Plastic Surgery

Australian researchers conducted a cross-sectional study of 495 patients – 302 women and 193 men – who presented for airway assessment and were assessed both for nasal function and mental health, including body dysmorphia. 

They found that patients who had poorer scores on mental health reported greater symptoms of nasal obstruction on both sides, and were more likely to report the obstruction as severe or worse, compared with individuals with healthier mental wellbeing. 

But when researchers compared objective measures of nasal function using airflow analysis, they found the measures were similar between patients with good mental health scores and those with low scores. They did note, however, ‘subclinical’ differences in nasal peak inspiratory flow, which favoured patients with better mental wellbeing. 

The researchers also saw a difference based on the measures of mental wellbeing; individuals who had low self-esteem scores had poorer perceived nasal function whereas those with higher body dysmorphia scores did not show significant differences in reported nasal symptoms. 

‘Hence, we have demonstrated that impairments in general mental well-being and self-esteem, but not dysmorphia, may translate to a negative self-evaluation of nasal function and influence the motivation for surgery,’ the researchers wrote. 

Commenting on the study, otolaryngologist head and neck surgeon and subspecialist rhinoplasty surgeon, Mr Stephen Floreani stated that although previous rhinoplasty studies had focused largely on associations between body dysmorphia and less satisfied patients after surgery, this study examined the effect of poor mental health on perceived nasal function. 

‘Patients with dysmorphia don’t seem to interpret their functional issues any differently from the normal population,’ said Mr Floreani, surgeon at Adelaide’s Memorial, Calvary and Queen Elizabeth Hospitals. 

‘Patients with poor mental health and low self-esteem are more likely to report that they have a functional issue with their nose, when in fact the objective parameters do not corroborate that impression.’ 

Mr Floreani told Medicine Today that patients experiencing functional nasal problems needed to be carefully assessed for clinical findings that could support an issue with nasal obstruction. 

‘In the absence of any physical problems, such as structural issues with the septum, turbinates, nasal valves or chronic sinus disease, it is possible that mental health issues may be a contributing factor in their symptomatology,’ he said.
JAMA Facial Plast Surg 2017; doi: 10.1001/jamafacial.2017.0459.

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